Department of Traditional Chinese Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China.
Department of Nephrology, Jiangsu Provincial Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong Road, Nanjing 210029, China.
J Ethnopharmacol. 2014 Feb 12;151(3):1079-1089. doi: 10.1016/j.jep.2013.12.005. Epub 2013 Dec 19.
Transforming growth factor (TGF)-β1/Smad signaling pathway plays a critical role in the prolonged glomerulosclerosis (GS), which is an important determinant during the progression in chronic kidney disease (CKD). For recent 30 years, multi-glycoside of Tripterygium wilfordii Hook. f. (GTW), an extract from Chinese herbal medicine has been proved clinically effective in improving GS in CKD in China. However, therapeutic mechanisms involved in vivo are still unclear. In this study, we aimed to explain the dose-effects and molecular mechanisms of GTW on GS by regulating TGF-β1/Smad signaling activity in adriamycin (ADR)-induced nephropathy (ADRN).
Rats with ADRN, created by unilateral nephrectomy and twice adriamycin injections (ADR, 4 mg/kg and 2 mg/kg) within 4 weeks, were divided into four groups, the Sham group, the Vehicle group, the low-dose GTW-treated group, and the high-dose GTW-treated group, and that, sacrificed at the end of the 6th week after administration. Proteinuria, blood biochemical parameters, glomerulosclerotic morphological makers, podocyte shape, and nephrin expression were examined, respectively. Protein expressions of key signaling molecules in TGF-β1/Smad pathway, such as TGF-β1, Smad3, phosphorylated-Smad2/3 (p-Smad2/3), and Smad7, were also evaluated individually.
The results indicated that the characterizations of ADRN involved the typical prolonged GS, a small amount of abnormal proteinuria, and the failing renal function; TGF-β1/Smad signaling molecules, especially Smad3, p-Smad2/3, and Smad7 were activated in vivo, accompanied by the exasperation of glomerulosclerotic lesion; GTW at high-dose (100 mg/kg) and low-dose (50 mg/kg) could slightly ameliorate the prolonged GS and nephrin expression, furthermore, the anti-proliferative action of GTW at high-dose was superior to that at low-dose, but caused the significant liver injury; in ADRN model rats, protein expressions of TGF-β1, p-Smad2/3, and Smad7 in the kidneys could be regulated with the treatment of GTW at low-dose.
This study farther demonstrated that the low-dose of GTW, as a natural regulator in vivo, could effectively and safely ameliorate the prolonged GS in FSGS model, via the potential molecular mechanisms involving the reduction of ECM components and the suppression of TGF-β1 over-expression, as well as the bidirectional regulation of TGF-β1/Smad signaling activity.
ETHNOPHARMACOLOGICAL 相关性:转化生长因子 (TGF)-β1/Smad 信号通路在肾小球硬化症 (GS) 的长期进展中起着关键作用,这是慢性肾脏病 (CKD) 进展过程中的一个重要决定因素。近 30 年来,从中药中提取的雷公藤多苷 (GTW) 已被临床证明在改善中国 CKD 中的 GS 方面具有疗效。然而,体内的治疗机制仍不清楚。在这项研究中,我们旨在通过调节 TGF-β1/Smad 信号活性来解释 GTW 在阿霉素 (ADR) 诱导的肾病 (ADRN) 中对 GS 的量效和分子机制。
通过单侧肾切除术和 4 周内两次阿霉素注射(ADR,4mg/kg 和 2mg/kg)创建 ADRN 的大鼠,分为四组:假手术组、载体组、低剂量 GTW 治疗组和高剂量 GTW 治疗组,分别在给药后第 6 周末处死。分别检测蛋白尿、血液生化参数、肾小球硬化形态标志物、足细胞形态和肾脏素表达。还单独评估了 TGF-β1/Smad 通路中的关键信号分子的蛋白表达,如 TGF-β1、Smad3、磷酸化 Smad2/3(p-Smad2/3)和 Smad7。
结果表明,ADRN 的特征涉及典型的长期 GS、少量异常蛋白尿和肾功能衰竭;TGF-β1/Smad 信号分子,特别是 Smad3、p-Smad2/3 和 Smad7,在体内被激活,伴有肾小球硬化病变的加剧;高剂量(100mg/kg)和低剂量(50mg/kg)的 GTW 可轻微改善长期 GS 和肾脏素表达,此外,高剂量的 GTW 具有抗增殖作用优于低剂量,但会导致明显的肝损伤;在 ADRN 模型大鼠中,GTW 低剂量治疗可调节肾脏中 TGF-β1、p-Smad2/3 和 Smad7 的蛋白表达。
本研究进一步表明,低剂量 GTW 作为体内天然调节剂,可通过减少 ECM 成分和抑制 TGF-β1 过度表达的潜在分子机制,以及 TGF-β1/Smad 信号活性的双向调节,有效且安全地改善 FSGS 模型中的长期 GS。